Dr. Vaknin: According to orthodoxy, between 0.7%-1% of the adult population suffer from the Narcissistic Personality Disorder. This figure is an underestimate. Pathological narcissism is under-reported because, by definition, few narcissists admit that anything is wrong with them and that they may be the source of the constant problem in their life and the lives of their nearest or dearest. Narcissists resort to therapy only in the wake of a harrowing life crisis. They have alloplastic defenses - they tend to blame the world, their boss, society, God, their spouse for their misfortune and failures. Last, but not least, psychotherapists regard narcissists as "difficult" patients with a "severe" personality disorder - or, put plainly, lots of work with little reward. Narcissists, Paranoiacs and Psychotherapists Narcissistic Personality Disorder (NPD) At a Glance.

Doria57: Is there any way to get along with these type of people at work?

Dr. Vaknin: Here are a few useful guidelines:

Never disagree with the narcissist or contradict him.

Never offer him any intimacy. You are not his equal and an offer of intimacy insultingly implies that you are.

Look awed by whatever attribute matters to him (for instance: by his professional achievements or by his good looks, or by his success with women and so on).

Never remind him of life outside his bubble and if you do, connect it somehow to his sense of grandiosity.Do not make any comment, which might directly or indirectly impinge on his self-image, omnipotence, judgement, omniscience, skills, capabilities, professional record, or even omnipresence.

Bad sentences start with: "I think you overlooked & made a mistake here & you don't know & do you know & you were not here yesterday so & you cannot & you should, etc. These are perceived as rude imposition. Narcissists react very badly to restrictions placed on their freedom.

Linda3003: My husband is employed by a very large university, inspite of "outstanding" appraisals, many stolen ideas, marked increase in customer satisfaction and being very professional, he was resently fired. His boss did not like the acolaides my husband was receiving, etc. How does one combat the defamation?

Dr. Vaknin: Depends on your resources and your ability to accept recurrent interim defeats. Narcissistic bosses are very tenacious and resourceful. They are pillars of the community, usually widely respected and believed. They have at their disposal the entire wherewithal of the organization. People say "where there's fire, there's smoke". "If he was fired, there must have been a good reason for it", "Why couldn't he simply get along? He must be egocentric, a bad team player." And so on. It is un uphill battle. My advice to you is to team up with an anti-bullying group or to have an attorney look into wrongful dismissal charges.

freedom03: I would like to know if the narcissist is aware of what they are doing?

Dr. Vaknin: Aware, cunning, premeditated, and, sometimes, even enjoying every bit of it. But it is not malice that drives them. They believe in their own destiny, superiority, entitlement, exemption from laws promulgated by mere mortals. The narcissist regards himself as one would an expensive present, a gift to his company, to his family, to his neighbours, to his colleagues, to his country. Resistance calls for strenuous measures. Disagreement with the narcissist is bound to be the outcome of ignorance or obstructionism. Criticism is malevolent and ill-founded. The narcissist trusts that he has the full moral justification to battle his foes. To his mind, the world is a hostile place, full of Lilliputians who seek to shackle his genius, foresight, and natural advantages. They aim to harness and castrate - and they deserve his ire and the ensuing punishment he metes out to them in his infinite wisdom. It is a crusade against the injustice of not recognizing the narcissist's true place in this world - at the pinnacle.

David: Dr. Vaknin, earlier you mention that the narcissist would act empathetic to draw in his prey, so to speak. In light of that, here's the next question:

martha j: Can this person genuinely develop authentic empathy skills?

Dr. Vaknin: No, he cannot. Narcissists lack the basic machinery of putting themselves in other people's shoes. They react with fury and denial when confronted with the fact that persons in their environments are individual entities with their own idiosyncratic and specific needs, preferences, choices, fears, hopes, and expectations. This, the refusal to grant autonomy, is at the core of abuse, whether on the domestic front or at the workplace. To the narcissist, others are mere extensions, instruments of gratification, sources of narcissistic supply. And nothing more than that.

delaware1974: With so many people afflicted with this - why are we making it sound like a death sentence? All of us still need to move on with our lives ...are we supposed to give up and accept because it's hard? We spend alot of time talking about the negative or "escaping" the narcissist, "surviving" the narcissist, what about those of us that want to help them and NOT give up on them? Are there LIVE face-to-face help groups? Hope?